Objective To investigate the expression of serum procalcitonin(PCT) and interleukin-13(IL-13) in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with airway mucus hypersecretion and their relationship with clinical prognosis.Methods A total of 153 patients with AECOPD and airway mucus hypersecretion who were admitted to the First Affiliated Hospital of Hainan Medical College from April 2018 to March 2021 were selected as the research subjects. All patients received routine treatment and were followed up for 1 year. For the survival group and the death group. The baseline data, serum PCT, IL-13 and laboratory-related indexes were compared between the two groups. COX regression analysis was used to analyze the related factors of mortality in patients with AECOPD and airway mucus hypersecretion; receiver operating characteristic curve(ROC) was drawn to analyze the predictive value of serum PCT and IL-13 on clinical prognosis of AECOPD patients with airway mucus hypersecretion.Results Among the 153 patients with AECOPD and airway mucus hypersecretion, 31 patients(20.26%) died within 1 year, and 122 patients(79.74%) survived. The duration of COPD in the death group was longer than that in the survival group, and the initial cough and expectoration assessment questionnaire(CASA-Q) score lower than the survival group(t/P=2.667/0.009, 3.933/<0.001); the initial partial pressure of carbon dioxide(PaCO2), tumor necrosis factor-α(TNF-α), PCT, IL-13 in the death group were higher than those in the survival group, and the level of Alb was low In the survival group(t/P=4.628/<0.001, 3.340/<0.001, 6.728/<0.001, 6.878/<0.001, 5.527/<0.001). COX regression analysis showed that initial CASA-Q score and high Alb level were protective factors for the prognosis of patients with AECOPD and airway mucus hypersecretion, and high serum PCT and IL-13 levels were risk factors [HR(95%CI)=0.877(0.798-0.962), 0.751(0.647-0.871), 1.828(1.074-3.112), 1.065(1.013-1.120)]. The results of ROC curve analysis showed that the AUCs of serum PCT and IL-13 alone and in combination to predict the risk of death in patients with AECOPD and airway mucus hypersecretion were 0.856, 0.815, and 0.938, which had certain predictive value.Conclusion Serum PCT and IL-13 levels are associated with clinical prognosis in AECOPD patients with airway mucus hypersecretion.

Objective To investigate the risk factors and pathogenic bacteria of bloodstream infection in patients with severe respiratory failure treated with intravenous-venous extracorporeal membrane oxygenation(VV-ECMO).Methods A total of 90 patients with severe respiratory failure who received VV-ECMO treatment from October 2017 to October 2021 in the Department of Critical Care Medicine, Second Affiliated Hospital of Zhengzhou University were selected. 60 cases in the non-infection group and 30 cases in the bloodstream infection group. The clinical data, blood culture results, the immediate arterial blood gas analysis indexes when VV-ECMO was put on the machine, and the inflammatory indexes within 24 hours after the machine were compared between the two groups. Binary Logistic regression analysis was used. Risk factors for complicated bloodstream infections in VV-ECMO-treated patients.Results During VV-ECMO treatment, patients with bloodstream infection accounted for 33.3%(30/90), and patients with non-bloodstream infection accounted for 66.7%(60/90). Blood culture showed 33 strains of pathogenic bacteria: Gram-negative bacilli accounted for 54.5%(18/33), gram-positive bacilli accounted for 9.1%(3/33), gram-positive cocci accounted for 33.3%(11/33), and fungal infections accounted for 33.3%(11/33). Among the Gram-negative bacilli, Klebsiella pneumoniae and Acinetobacter baumannii were the most common species(27.2% and 18.2%, respectively). Arterial blood pH, partial pressure of carbon dioxide(PaCO2), partial pressure of oxygen(PaO2), oxygen saturation(SaO2), inflammatory indexes C-reactive protein(CRP), procalcitonin(PCT) were measured in the two groups of patients), interleukin 6(IL-6) and white blood cell count(WBC), there was no significant difference(P>0.05). Higher duration of mechanical ventilation, high arterial blood glucose level, and bleeding at the site of puncture and catheterization were independent risk factors for bloodstream infection in patients with respiratory failure treated with VV-ECMO [OR(95%CI)=1.137(1.008-1.283), 1.372(1.080-1.742), 4.170(1.172-14.843)].Conclusion The most common pathogens associated with bloodstream infections after VV-ECMO were gram-negative bacilli, Klebsiella pneumoniae, and Acinetobacter baumannii; higher duration of mechanical ventilation, higher random arterial blood glucose levels when VV-ECMO was started, and Bleeding events at the puncture cannula are an independent risk factor for bloodstream infection in patients with severe respiratory failure treated with VV-ECMO.

Objective To explore the correlation between the expression of plasma urothelial carcinoma antigen 1(UCA1), microRNA-1(miR-1) and myocardial injury in patients with acute ST segment elevation myocardial infarction(STEMI).Methods One hundred and twenty-four patients with STEMI admitted to the Cardiovascular Department of Third Chengdu People's Hospital from March 2016 to March 2021 were selected as the study subjects(STEMI group), and 116 health examinees in the same period were selected as the healthy control group. Plasma was collected from both groups to detect the expression of UCA1, miR-1 and the levels of creatine kinase isoenzyme(CK-MB) and troponin I(cTnI), the indicators of myocardial injury. Pearson correlation analysis was used to analyze the expression of plasma UCA1 and the expression of miR-1, cTnI Correlation of CK-MB levels. The ROC curve is used to analyze various indicators to predict the value of STEMI.Results The expression level of UCA1 in STEMI group was significantly lower than that in healthy control group(t/P=31.648/<0.001), while the expression level of miR-1, cTnI and CK-MB in STEMI group were significantly higher than that in healthy control group(t/P=32.786/<0.001,17.663/<0.001,24.383/<0.001). Pearson analysis showed that the expression of UCA1 in plasma was negatively correlated with miR-1, cTnI, CK-MB(r=-0.755,-0.581,-0.646,P<0.001). The ROC curve analysis showed that the AUC of AMI predicted by the expression of UCA1, miR-1 and the levels of cTnI and CK-MB were 0.992, 0.995, 0.982 and 0.972 respectively.Conclusion The expression of UCA1 in plasma of patients with ST segment elevation myocardial infarction is significantly decreased, while the expression of miR-1 is significantly increased, which is negatively correlated, and can become a new marker for early prediction of ST segment elevation myocardial infarction.

Objective To investigate the lipid-lowering efficacy and serum endothelin-1(ET-1) and von Willebrand factor(vWF) of evolumab combined with rosuvastatin in patients with acute myocardial infarction after percutaneous coronary intervention(PCI). level of influence.Methods A total of 96 patients with acute myocardial infarction who underwent PCI from September 2020 to September 2021 were selected as the research subjects, and divided into an observation group and a control group according to the random number table method, with 48 cases in each. The control group was treated with rosuvastatin, and the observation group was treated with evolocumab on the basis of the control group. Glycerol(TG), lipoprotein a(Lp-a)], vascular endothelial function [ET-1, vWF, nitric oxide(NO)], inflammatory markers [tumor necrosis factor-α(TNF-α), interleukin 6(IL-6), high-sensitivity C-reactive protein(hs-CRP)], cardiac function [left ventricular ejection fraction(LVEF), left ventricular end-systolic diameter(LVESD), left ventricular end-diastolic diameter(LVEDD)], and coronary angiography results after treatment, adverse reactions during treatment. The Kaplan-Meier survival analysis was used to compare the major adverse cardiovascular events(MACE) between the two groups during the 6-month follow-up period.Results After 3 months of treatment, the serum levels of LDL-C, TC, TG and Lp a in the observation group were lower than those in the control group(t/P=8.657/<0.001, 12.656/<0.001, 2.571/<0.001, 4.883/<0.001); The levels of ET-1 and vWF were lower than those of the control group, and the levels of NO were higher than those of the control group(t/P=5.772/<0.001, 4.172/<0.001, 4.465/<0.001); the levels of serum TNF-α, IL-6 and hs CRP were lower than those of the control group(t/P=4.256/<0.001, 7.238/<0.001, 3.879/<0.001); LVEF was higher than that of the control group, LVESD and LVEDD were lower than those of the control group(t/P=4.811/<0.001, 3.715/<0.001, 4.618/<0.001). There was no significant difference in TIMI grade 3 between the two groups(P>0.05). The proportion of MBG grade 2-3 in the observation group was higher than that in the control group(χ2/P=5.352/0.021). The Kaplan Meier survival curve showed that the cumulative incidence of MACE in the observation group was lower than that in the control group(16.67% vs 4.17%,χ2/P=3.891/0.049). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion Evolocumab combined with rosuvastatin can effectively reduce blood lipid levels, improve vascular endothelial function and cardiac function, inhibit inflammatory response, and reduce the incidence of MACE, with good safety.

Objective To investigate the relationship between serum syndecan-1(syndecan-1) and ficolin-3(Ficolin-3) levels and cardiac function and prognosis in patients with heart failure(HF).Methods Selected from January 2019 to January 2021 in the Department of Cardiology, Cangzhou People's Hospital, Hebei Province, 109 patients with HF(HF group), who were divided into grade II subgroup 35 cases and grade III subgroup according to the New York Heart Association(NYHA) classification 46 cases, 28 cases in the grade IV subgroup, and 60 healthy volunteers who underwent physical examination in the hospital during the same period were selected as the healthy control group. The serum levels of syndecan-1, Ficolin-3, B-type natriuretic peptide(BNP), and N-terminal B-type natriuretic peptide precursor(NT-proBNP) was detected. Echocardiography was used to detect left atrial diameter(LA), left ventricular end-diastolic Internal diameter(LVEDD), left ventricular posterior wall thickness(LVPWT), left ventricular ejection fraction(LVEF), and the occurrence of end-point events after discharge. Pearson analyzed the correlation of serum syndecan-1, Ficolin-3 with BNP, NT-proBNP, LA, LVEDD, LVPWT, LVEF, Logistic regression analysis of the related factors affecting the prognosis of HF patients, receiver operating characteristic curve(ROC) analysis of serum syndecan-1, Value of Ficolin-3 in predicting prognosis in HF patients.Results The serum levels of syndecan-1 and Ficolin-3 in HF group were higher than those in healthy control group(t/P=39.469/<0.001, 12.086/<0.001). Comparison of serum syndecan-1, Ficolin-3, BNP, NT-proBNP levels and LVEDD, LA, LVPWT, grade IV subgroup > grade III subgroup > grade II subgroup(F/P=82.230/<0.001, 113.225/<0.001, 116.335/<0.001, 183.528/<0.001, 247.916/<0.001, 84.451/<0.001, 163.446/<0.001), LVEF was compared in grade IV subgroup

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